The transformation of the Roman world under Augustus (ruled 31 BC to AD 14), the heir of Julius Caesar, was not just a political transition from Republic to Empire, from the effective rule of the Senate and people of Rome to an autocracy hiding behind traditional terminology. It was also a social and geographical revolution as Roman imperial power was extended to the Rhine, the Danube and the Euphrates. Whether in N. Italy, Gaul or Asia Minor, local elites were assimilated, in a variety of ways, into the wider system of Roman government and Roman culture. The city of Rome itself was changed almost beyond recognition as marble public buildings replaced brick and apartment blocks took over from cottages. The population of the city grew enormously, and the city's boundaries had to be extended with all due religious pomp and ceremony. Amid this flood of immigrants (a veritable river Orontes, sneered one satirist) came Greek doctors, from Thebes (whether the town in Boeotia or Egypt is not clear), from Nicaea, Laodicea, Smyrna and other less prestigious towns all over the Eastern Mediterranean. 1 They sought fame and fortune in the metropolis, in Italy, in the more Romanised provinces of the West and, in a few cases, even on the very fringes of the Western Empire. 2 The passage of Greek medicine into the Roman world was now so complete, with the same theories and often the same medicaments circulating in Latin as well as in Greek, that one can now truly begin to talk of Roman medicine as something that could be found across the Empire without any distinction of language.
At the very apex of the ambitions of medical practitioners was now the imperial household, the emperor, his family, their friends, advisers, and particularly in the first century AD, the ex-slaves (or freedmen) who acted as imperial secretaries. Becoming the personal physician to one of these grandees was, as will be shown later, a sure path to wealth and influence, for one's family as well as oneself. But even the suggestion of imperial approval could be used to promote a theory or vindicate a novel drug. Paccius Antiochus, on his